Provider Demographics
NPI:1235682923
Name:PIETRZYK, HALIE MICHELLE (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:HALIE
Middle Name:MICHELLE
Last Name:PIETRZYK
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:HALIE
Other - Middle Name:MICHELLE
Other - Last Name:CULLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9832 SETON DR
Mailing Address - Street 2:
Mailing Address - City:OLMSTED TWP
Mailing Address - State:OH
Mailing Address - Zip Code:44138-4245
Mailing Address - Country:US
Mailing Address - Phone:419-239-4892
Mailing Address - Fax:
Practice Address - Street 1:8668 DAY DR
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-5692
Practice Address - Country:US
Practice Address - Phone:440-340-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-28
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND.2016329235Z00000X
OHSP.12710235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist